It didn't exterminate entire civilizations: leaving a pitiful remnant of shell-shocked survivors to envy the dead and wonder why their gods had forsaken them amidst the ruins of their culture is an important part of the smallpox outreach approach!

Actually, some ethnic groups are believed to have been completely exterminated by smallpox. For instance, the Beothuk tribe of Newfoundland, had only one survivor of a smallpox epidemic, and she later died with no offspring. Smallpox first spread through the Americas in the early 1500s, when most tribes were pre-literate, so there are probably some other exterminated tribes that are lost to history.

Considering how many doctors used to inoculate for smallpox, a lot. There's probably envelopes containing spores in old collections. Hope they're dead.

Wait, I was alive during that time -- the smallpox vaccine wasn't made from smallpox, it was made from cowpox. So samples of the vaccine would not be smallpox, dead or otherwise. Samples of smallpox would be from labs specifically testing the disease. (Hopefully, testing for means to eradicate it.)

I strongly suggest you read more. There were other [wikipedia.org] ways of innoculating against smallpox

Indeed. Direct inoculation with pus or scabs from smallpox pustules was used long before vaccines were discovered. These inoculations had about a 2% mortality rate, compared with ~30% for those contracting the airborne virus. Knowledge of inoculation spread from China, through the Muslim world, into Africa. African slaves taught the technique to Americans. From there it spread to Europe. Vaccinations (based on cowpox) came centuries later.

According to Wikipedia, this is not quite true. Chinese did discover the practice in the 10th century, and reports on the practice were given to the Royal Society in 1700, but no action was taken.

The Ottomans learned it before the early 18th century, but we don't know for certain how or when it got there. They also reported on it to the Royal Society in 1714 and 1716, but nobody paid much attention until the wife of the British Ambassador to the Ottomans witnessed it and introduced it to Europe's ruling e

Before the vaccine was invented, they had inoculation -- bits of smallpox scabs injected into a person. This means that a couple centuries ago, your average doctor would have had smallpox laying around to inoculate patients with. Any old medical something-or-other from the 1700s could contain smallpox.

I doubt the virus is still alive if the sample is from the 1700s. Modern viral storage techniques didn't come about until the 20th century and even then it was still a troublesome aspect in most industrialized countries, and a big part of biowarfare research (gotta keep the virus capable despite being loaded into bombs, rockets, and other dispensers). Seeing that the US and Soviets had a massive problem getting this to work for many kinds of viruses I seriously doubt that some guy in the 1700s who didn't ev

Wait, I was alive during that time -- the smallpox vaccine wasn't made from smallpox, it was made from cowpox. So samples of the vaccine would not be smallpox, dead or otherwise. Samples of smallpox would be from labs specifically testing the disease. (Hopefully, testing for means to eradicate it.)

And only a decade or so ago, smallpox was effectively eradicated from the world - a win for vaccinations.

Of course, then we had the whole anti-vaxxer thing and now, smallpox is back and as infectious as ever. And

Wait, I was alive during that time -- the smallpox vaccine wasn't made from smallpox, it was made from cowpox. So samples of the vaccine would not be smallpox, dead or otherwise. Samples of smallpox would be from labs specifically testing the disease. (Hopefully, testing for means to eradicate it.)

And only a decade or so ago, smallpox was effectively eradicated from the world - a win for vaccinations.

Of course, then we had the whole anti-vaxxer thing and now, smallpox is back and as infectious as ever. And you thought whooping cough was bad. All these controlled diseases are now rampaging communities again, except instead of in poorer nations in Africa and the like where the lack of medical care derives from corrupt governments and poverty, it's in first-world nations with access to clean water, medical aid, education, etc.

Wait a minute. People haven't been regularly vaccinated for Smallpox since 1971. (Don't take my word for it, check the Journal of the American Academy of Pediatrics.) Not because of "the anti-vaxxer thing" but because the disease was eradicated. *Four* decades ago. This is why you don't see people in civilized countries with smallpox vaccination scars who aren't old enough to be grandparents.

According to the CDC, the last known case in the US was 1945 and the last naturally occurring case in the world

Indeed. As it turns out, the greatest threat to mankind is not necessarily from power-crazed world-leaders sitting on huge arsenals, but from people who didn't care enough, didn't think far enough ahead and didn't understand what they were dealing with.

Sure. Let's vaccinate against a disease that is eradicated in the wild. Never mind the possibility (likelihood, in a large enough population) of adverse side effects - eczema vaccinatum, progressive vaccinia, and postvaccinal encephalitis, for example. (14-52 people per million vaccinated, or.0014%-.0052%.)

No vaccine is side effect free. In most cases, the risk of the side effects is justified by the fact that their likelihood is far, far lower than the likelihood of the disease in an unvaccinated population, and they tend to be far lower in severity than the disease. But for smallpox, given that it no longer occurs in the wild, the risk is unjustifiable.

But for smallpox, given that it no longer occurs in the wild, the risk is unjustifiable.

There are some people, however... that should always be vaccinated against Smallpox:

1. Anyone working at the secure facility where these samples are stored; especially any lab workers, security guards, and cleaning staff.
2. Anyone working at a facility where the samples are used to study Smallpox are being handled.
3. Healthcare professionals, doctors/nurses/... that see patients and are occasionally exposed to people with various skin diseases or work in foreign countries where smallpox used to be prevalent.
4. Everyone that any of the people above are in daily contact with.

Wouldn't that make it that much harder to track down the source in the event of an outbreak? If, say, a janitor or janitrix at Acme Carwash and Research Centre is among the first people to succumb to the disease, that would be a fairly obvious clue. If he or she is inoculated, however, and merely acts as a spore carrier and infects a random stranger on the bus, the source will be that much harder to track.

You might want to look up the "Swine Flu Scare of 1976". A few cases of swine flu infected some recruits on a military base in New Jersey. Public health officials fearing an outbreak began a mass vaccination campaign costing over a hundred million dollars, up to 500 cases of Guillain–Barré syndrome, and at least 25 deaths. All to stop a flu that never exceeded 5 infections contained to Fort Dix, and only 1 death directly attributable to the flu. Vaccines can be a great thing, they have came a

[vaccination caused] 25 deaths. All to stop a flu that never exceeded 5 infections contained to Fort Dix

Yes, but you can't go back in time and discover what would have happened if they didn't mass vaccinate. Sure dumb luck may have caught all five cases before it spread further, but do you want to bet your life on dumb luck?

[vaccination caused] 25 deaths. All to stop a flu that never exceeded 5 infections contained to Fort Dix

Yes, but you can't go back in time and discover what would have happened if they didn't mass vaccinate. Sure dumb luck may have caught all five cases before it spread further, but do you want to bet your life on dumb luck?

Yup, this sounds a bit like Y2K in retrospective. Was money wasted on it because it turned out to be a non-event, or was it a non-event because so much was spent on it?

The fact of the mater is though that it never did spread past the base, you can argue what "might have" happened till you're blue in the face but that still doesn't change the fact that even if no one had been vaccinated the other measures taken (quarantine, assessment of proximate personnel, public advisories, etc) at least in this case prevented the spread of the disease. If this had been an auto manufacturer and some safety mechanism that never saved a life but had resulted in 25 deaths, hundreds of deb

but if we just preemptively vaccinate then city zero won't be an issue.

The Vaccine for Smallpox is not entirely safe, because the vaccine consists of essentially another virus called Vaccinia.

This is an infectious virus; the Smallpox Vaccine infects the person who has been vaccinated.

Unlike many other Vaccines -- however, there are significant rates of adverse reaction. Further improvements to the vaccine require human testing, and since the disease has been deemed eradicated --- no improvements can really be made:

Average 1 in 1 to 2 million people vaccinated result in deaths, many more people experience severe complications but don't die.
If there are 300 million people vaccinated; then you could estimate that 300 people would die of complications.
It is quite unlikely for you to be one of the 300.......... it's also unlikely for the Smallpox vaccine to help you against Smallpox in the future. Still..... the complications can be pretty nasty, even if you do survive.
Most people should probably deem the extra protection not worth the more immediate very real dangers:

Vaccinia necrosum: Progressive tissue death ("necrosis") at the original injection site. 1 persion per 1 to 2 million vaccinations; almost always fatal before availability of vaccinia imunoglobins; people with T-Cell deficiencies are particularly at high risk.

Eczema Vaccinatum. Too horrible to think of; people who already have some form of eczema, atopic dermatitis, or sensitive skin are at high risk and fatalaties have resulted in the past. Virus produces extensive lesions throughout the skin. Patient's life may be saved with early hospitalization and urgent treatment.

1 in 242 million vaccinated will contract a generalized vaccinia infection -- involving pustules forming about the skin distant from the site of injection and generalized rashes throughout the body; for some patients with weakened immune systems, this results in a toxic and potentially fatal course.

1 in 1 million people to be vaccinated on average, develop a systemic reaction to the vaccine which has a likelihood of fatal outcomes; people who have been immunocompromised or have a weak immune system are particularly susceptible.

Even more people have a severe adverse reaction which may be crippling or severe enough to give one pause about if one really needs the vaccine. Is it an appropriate risk tradeoff? What is the true risk of contracting smallpox VS the cost of taking the vaccine?

Successful vaccination always produces a lesion at the vaccination site, within 4 days, and it will leave a permanent mark which may be undesirable; this will be highly itchy, and highly infectious --- easily carried by clothing, and easily transferred to hands or other body parts to come in contact with it. Contact or contact with anything that touched the lesion may result in infection/lesions of vaccinia on other part of the body, and also: contact with other people ("inadvertent vaccination of friends or family, for example").

Weeks of malaise and discomfort after the vaccination are essentially guaranteed; the vaccine will essentially almost definitely make you feel sick, and likely for 3 to 7 days, similar to a cold.

17% to 20% of vaccinees experience a fever exceeding 100 degrees, during the first 2 weeks after vaccination, and plenty of vaccinated experience a fever exceeding 102F for the first 5 days.

Most people vaccinated experience significant irritation at the vaccination site: including significant soreness, and a variety of kinds of skin rashes plus myalgia lasting 5 to 7 days. More rarely: Stevens-Johnson syndrome results, in which necrosis ("tissue death") of the skin results, in a life-threatening condition involving the dermis of the skin separating from the epidermis.

This is all funny to me. I have been vaccinated 4 times for smallpox. Once as a child (thank you modern medicine!) and three times in the past decade (thank god for wiped databases:( ).

Every single time it has left a permanent scar as your post says. Every single time in the past decade, it has made me feel like crap for at least a week, sometimes two weeks. Every single time, dealing with a live virus on the skin has been a HUGE pain in the ass. Thankfully, I have never had any actual severe adverse react

Nice to know they actually keep track of these things. What's next? "Nuke found in sandbox"

Consider this: 50 years ago, they were just samples of a common infection --- no extraordinary accounting or
security measures were required, and it's certainly possible that a number of samples slipped through the cracks
and have been "lost" and are just out there somewhere.

Who would have known that Smallpox would eventually be mostly eradicated, and security would ever be a concern?

A common infection that killed more people in the 20th century than all wars put together. It's shocking to think that someone would carelessly misplace a vial of an airborne infectious agent with a mortality rate above 20%, even in the mid-20th century. Smallpox is hands-down the deadliest disease in human history - the only reason it could be eradicated was the lack of non-human reservoirs. I'm not particularly afraid of nuclear war, but the thought of smallp

It's shocking to think that someone would carelessly misplace a vial of an airborne infectious agent with a mortality rate above 20%

We don't know for a fact that this particular copy of Smalllpox was one of the highly fatal versions.
I'm sure this was not careless, as it was appropriately stored. They apparently just lost track of the fact that it was there and where it was, in terms of recordkeeping and careful management of the research specimens.

Seeing as the vial was quite carefully freeze-dried, sealed, and placed into the cold storage, in
a lab where dangerous specimens would ordinarily be stored, requiring the appropriate training of staff for safe handling of such samples: it was really no danger.

Cold storage in vials boxed up is not unusually risky treatment for an infectious agent. I am sure if you looked at more dusty boxes in the cold storage at the various laboratories and regulators, you would find numerous examples of very serious highly-infectious agents, including plenty of examples of Ebola, Marburg, Nipah, SARS, West Nile, Poliomyelitis/Polio, Hepatitis, Pappataci (Yellow Fever), Measles, Spanish flu, HIV, Tuberculoisis, .

A common infection that killed more people in the 20th century than all wars put together.

Smallpox didn't start in the 20th century; its prominence in the 20th century was a culmination of over 500 years of infecting humans.. in the early 20th century, there were many diseases, and it's not so clear to what degree Smallpox actually cut lives significantly shorter than they otherwise would have been. Smallpox caused a lot of deaths, and there were highly virulent strains that developed, but most strains were not so highly deadly and not necessarily airborne either; Variola Minor vs Variola Major, etc, etc.... It didn't kill all the humans(TM) like the black death almost did, else, we wouldn't be around to talk about it, as Smallpox was very tenacious and nasty.... but not necessarily the absolute worst virological threat that we have known as a species.

Why not destroy it? You and I along with the rest of us damn well know the virus has been sequenced and stored on file someplace. Not sure how trivial is it for a superpower's military complex, but pull the file and synthesize the virus again as a bioweapon with extra bonus features coded in. So again, why keep it physically around? Are we trying to usher in one of the four horseman or what?!

The trouble is, we may in the future discover that the sequenced DNA does not suffice. Or that there's an error. If we don't have reference material, we can't fix any such errors, or even discover them in the first place.

This is kinda like deciding a project is no longer needed, so instead of archiving it, you compile one last binary, then destroy all the source code.

actually finding this makes a good point that they were actually correct and should not destroy them. lets just say that this virus got out and we destroyed our remaining stocks, would that not make it harder to make a modern vaccine?

Guessing you never read the article. Had you done so, you would have seen this bit:

"[E]mployees discovered vials labeled ”variola,” commonly known as smallpox, in an unused portion of a storage room in a Food and Drug Administration (FDA) laboratory located on the NIH Bethesda campus."

I think this is the biggest risk when it comes to a possible new outbreak. Some uneducated people clean out a lab of storage facility and just throws everything in a dumpster without knowing what they are working with.

It has happened before with other stuff (medical records, computers etc.) and it will happen again. The question is if there is something somewhere that is a major danger. Even worse is if there are some vials with biological warfare material that makes Ebola seem like a common cold. Since much of that research is done secretly it's not easy to know - and in some cases everyone that knows may have passed away and the remains of those projects are just stored in a warehouse with a reference to some documents that have been shredded a decade or more ago.

I just saw a report on the discovery of the Ebola Virus back in the late seventies. Back then the samples of a new unknown deadly disease from missionaries in Congo were put in card board boxes that were carried through Antwerp city (Belgium) on foot, taking them to the university for analysis under an electron microscope.
The virus was isolated in a normal room back then and stored in a thermos.
source: Prof. EM. Guido Van Der Groen (Virologist)